Gastrointestinal Disorders NCLEX RN
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Question 1 of 5.
The nurse has educated a client scheduled to have an endoscopic retrograde cholangiopancreatography (ERCP). Which of the following client statements would indicate the need for additional teaching by the nurse? Select all that apply.
A. I will not be able to eat or drink anything for six to eight hours before this procedure.
B. I will have to do a bowel prep before this procedure.
C. Someone will have to drive me home after this procedure.
D. I should notify my physician if I have abdominal pain and distention for one or two days following this procedure.
E. I can expect to have white stools one to two days following this procedure.
Explanation: Bowel prep (B) is not typically required for ERCP. Persistent pain and distention (D) post-ERCP require immediate notification, not delayed. White stools (E) are not expected post-ERCP. Fasting (A) and needing a driver (C) are correct.
Question 2 of 5.
The nurse is caring for a client with appendicitis experiencing pain. Which pain relief method would be inappropriate for this client?
A. Applying ice packs to the abdomen
B. Practicing breathing exercises with the patient
C. Using a heating pad on the abdomen
D. Encouraging rest
Explanation: Using a heating pad on the abdomen is inappropriate for a client with appendicitis as it may increase inflammation or risk perforation of the appendix. Ice packs, breathing exercises, and rest are safer and more appropriate for pain management.
Question 3 of 5.
Extract:The following scenario applies to the next 1 items The nurse is caring for an older adult in the medical-surgical unit Item 1 of 1 Health History 84-year-old female was admitted to the medical-surgical unit with a three-day history of abdominal pain, distention, nausea, and persistent vomiting. She reports that she has not had a bowel movement in five days and has no appetite. Vital Signs Oral temperature 101.1° F (38.3° C) Pulse 108/minute Respirations 22/minute Blood pressure 100/64 mm Hg Oxygen saturation 96% on room air.
The nurse reviews the client's health history and vital signs. Click to specify if the findings are consistent with a small bowel obstruction or appendicitis. Each row must have at least one but may have more than one response option selected.
| Description | Options |
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Explanation: Small bowel obstruction: A (Unable to pass stool), B (Fever), C (Distended abdomen), E (Nausea and vomiting). Appendicitis: A, B, C, D (Right lower quadrant abdominal pain), E. Both conditions can present with these symptoms, though right lower quadrant pain is more specific to appendicitis.
Question 4 of 5.
Extract:The following scenario applies to the next 1 items The nurse in the emergency department (ED) cares for a 21-year-old male client Item 1 of 1 Nurses' Notes 1650: Client reports severe abdominal pain that radiates to his left shoulder. The client was tossing around the football with friends, and after being tackled, he began experiencing intense pain that worsened. He denies any medical history but is currently being treated for infectious mononucleosis and 'needed to get some fresh air,' so he started playing football with friends. During the assessment, the client was alert and fully oriented. He reports his abdominal pain is in the left upper quadrant, which radiates to his shoulder, as an 8/10 on the Numerical Rating Scale. Slight bruising was noted on the client's abdomen. A blotchy rash was observed on his back. His abdomen was slightly distended, taut, and tender to touch. Lung sounds are clear bilaterally. Peripheral pulses 2+. Skin is hot to the touch. Cervical lymphadenopathy is present. Vital signs: T 100.4°F (38°C), P 110, RR 21, BP 115/76.
Which of the following assessment findings require immediate follow-up? Select all that apply.
A. Reports of abdominal pain
B. Temperature
C. Pulse
D. Rash
E. Cervical lymphadenopathy
F. Abdominal assessment findings
Explanation: Severe abdominal pain (A), elevated pulse (C), and abnormal abdominal findings (F) such as distention and tenderness suggest a serious condition like a ruptured spleen, especially given the history of trauma and infectious mononucleosis. These require urgent evaluation.
Question 5 of 5.
The nurse is caring for a client who has ulcerative colitis (UC). The nurse should teach the client to [Select all that apply].
A. Eat consistent amounts of carbohydrates at mealtimes.
B. Avoid drinking fluids with meals.
C. Obtain recommended colon cancer screenings.
D. Avoid taking anti-diarrheal medication.
E. Increase the intake of non-caffeinated fluids during exacerbations.
Explanation: For ulcerative colitis, avoiding fluids with meals (B) aids digestion, regular colon cancer screenings (C) are critical due to increased risk, and increasing non-caffeinated fluids (E) prevents dehydration during exacerbations. Consistent carbohydrates (A) are not specific, and anti-diarrheals (D) may be used cautiously.
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